title: [Severe bronchiolitis. Changes in epidemiology and respiratory support].
abstract: BACKGROUND
  Bronchiolitis generates lots of admissions during the cold months in the paediatric intensive care units (PICU). New forms of respiratory support are being used and could improve the care of these patients.
  
  
  OBJECTIVE
  To analyse the epidemiological and respiratory support changes of children admitted to the PICU.
  
  
  METHODS
  An observational, retrospective, descriptive and analytical study of patients with the diagnosis of bronchiolitis admitted to the PICU of a tertiary hospital during the respiratory syncytial virus (RSV) epidemic months between 2005 and 2010.
  
  
  RESULTS
  A total of 229 patients were admitted, of whom 83% were infected with RSV. The mean age was 1.48 months, with children under 3 months being the greatest number of admissions (73.3%). December was the month with the highest number of admissions (52%). Mortality was 0.9%. The mean time of stay in the PICU and on respiratory assistance were 4 and 3 days, respectively (no significant differences between the periods studied). Patients with RSV bronchiolitis were younger than the negative RSV (mean 2.61 months and 4.05 months, P=.023). Active respiratory support was required in 73% of cases. The percentage of patients who required active respiratory support increased over the years (Z=3.81, P=.00014), especially high flow nasal oxygen therapy (Z=3.62, P=.00028). An inverse relationship was observed between patient age and length of stay in PICU (Beta=-0.245, P ≤.0001) and days on respiratory support (Beta=-0.167, P=.039).
  
  
  CONCLUSIONS
  Most patients admitted to the PICU are less than 3 months old. Mortality was 0.9%. Respiratory support (especially non-invasive mechanical ventilation and high flow nasal oxygen therapy) is used increasingly often. The youngest patients need more days in PICU and more respiratory support.
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. gonorootero@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Oñoro
authors.forename: E
authors.initials: E
authors.lastname: Pérez Suárez
authors.forename: M I
authors.initials: MI
authors.lastname: Iglesias Bouzas
authors.forename: A
authors.initials: A
authors.lastname: Serrano
authors.forename: A
authors.initials: A
authors.lastname: Martínez De Azagra
authors.forename: M A
authors.initials: MA
authors.lastname: García-Teresa
authors.forename: J
authors.initials: J
authors.lastname: Casado Flores
mesh_terms: D001990:Bronchiolitis, Viral / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology* / Q000628:therapy*; D012138:Respiratory Therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index